Sunday, May 14, 2006

just the way it is

Health is the second biggest Government portfolio, with a $9.6 billion annual budget, but fewer New Zealanders are getting operations. National Health spokesperson Tony Ryall notes that there are 180,000 people on hospital waiting lists, 25,000 of them have been on the list longer than six months, and of the 120,000 waiting to see a specialist, 8000 have been culled in the past year, meaning they were sent back to their doctors without going to a specialist.Of these 25,000, more than a quarter who have been given certainty of treatment or have been booked have been waiting longer than six months.

"Naughty," says the Government. Letters went off to seven District Health Boards reminding them that patients are not to be on waiting lists for more than six months, and could they do something about it - like kick people off. So they did.

Last month the Hawkes Bay District Health Board (DHB) announced that 1800 were to be culled from the waiting lists in one hit. This was since reduced to 900 after publicity, but Canterbury DHB is culling 2500 in the next two months. Capital Coast Health is yet to decide how many it will cull.

There are are around 31,000 New Zealanders in our top surgical waiting list group called “Booked/Certainty”. Mostly they are in near acute need, and will get most likely get surgery within six months.

The "waiting list forthe waiting list" is the “Active Review”. These 24,000 people who will not get the elective surgery they need-unless they have been assessed as likely to get more seriously ill within 18 months. Yet thousands have been on this list for longer than 18 months, and it is these people that are targetted for the chop. Some will die.

Some journalists have run stories of people who are not getting operations within six moths or have been shunted from waiting lists. The Health Minister refuses to discuss individual cases. These are people whose score for urgent surgery is the highest it can be: Joy Pipe (72) has spinal stenosis but has been culled from the waiting list. Letitia Grubb (15) has endometriosis and has missed months of school, but will probably not get surgery within the next six months. Also Robin McLean (40) had breast cancer and was told she has to wait nine months for an urgent diagnosis, so she went private, costing her $10,000. Obviously her taxes didnt pay for her health care.

Prime Minister Helen Clark says the issue is of management, not funding. Health Minister Pete Hodgson said the management of waiting lists was "unethical", which I thought was a rather strange comment from a Labour Cabinet Minister not particularly well thought of with regard to ethics.

Hodgson maintained there is no crisis. Top surgeons have rejected this. One said the waiting list cull was "unfair and cruel stupidity". A Government pledge to double hip and knee replacements by 2008 is seeing patients with equally serious conditions scratched from waiting lists for political rather than medical reasons - but Hodgson is crowing about the increase in hip and knee operations.

At this rate the waiting list for the waiting list will get so long that it will be bigger than the "booked certainty" waiting list. Next we will have a waiting list for the waiting list for the waiting list - and there will be a waiting list to get on that as well. You`ll have just as much chance of getting an operation if you put your name down on your shopping list - unless you are nearly dead, in which case you may as well not have a shopping list because you`ll be house-bound and drip-fed.

Pete Hodgson's response to the waiting lists? "It's just the way it is."